This editorial describes an effort by 9 consultation-liaison (C-L) Psychiatry service leaders in the United States to incorporate routine performance measurement into their service workflows. Although C-L Psychiatry is an essential clinical service in general hospitals, performance metrics for this service have not been broadly accepted or implemented. Meanwhile, the performance metrics that have been developed rely on an investment in resources and/or new workflows that C-L Psychiatry services may not be prepared to make on a widespread level. Our group sought to determine the feasibility of incorporating routine performance measurement into the workflows of a diverse sample of C-L Psychiatry services using only existing resources via three collection methods: timestamp review, chart auditing, and survey administration. No methods were broadly successful across the 9 services. We argue that for routine performance measurement to gain wider traction in the field of C-L Psychiatry, the ready availability-or automatability-of performance data must be taken into account.

Objective:
Consultation-liaison Psychiatry (CLP) services are particularly susceptible to heterogeneity, developing haphazardly in response to local interests and perceived need. This hampers the generalisability of comparisons between services in terms of service models, resource requirements and outcome data. The objective of this paper therefore is to chronicle the development of a method to meaningfully describe, map and compare different C-L Psychiatry services.

Method:
A review of the literature was followed by multiple site visits in both New Zealand and England, and an extended process of consultation and feedback.

Results:
Sixteen dimensions common to C-L Psychiatry services were extracted to create a multi-dimensional matrix (mMAX- LP) which had three broad clusters (structure, coverage and relationship with physical health services). The model was applied and discussed with the previously visited hospitals over the succeeding five years. Additionally, the matrix was tested, and its utility demonstrated during the planned reconfiguration of C-L Psychiatry services at a large teaching hospital in South Auckland, New Zealand by tracking the evolution of C-L Psychiatry services.

Conclusions:
mMAX-LP shows promise as a useful model for profiling and comparing C-L Psychiatry services; mapping their evolution over time; and sign-posting future service development.

Keywords:
mMAX-LP, consultation-liaison psychiatry, psychological medicine, psychosomatic medicine